Sharps Injuries and Exposures to Blood on the Rise: Physicians Now Outpace Nurses in Reported Exposure Incidents

LEAGUE CITY, Texas, Sept. 5, 2018 /PRNewswire/ -- Occupational exposure surveillance data collected by the International Safety Center from healthcare centers in the US reveal that workers have suffered an increase in needlesticks, sharps injuries, and blood and body fluid exposures (BBFEs) at work. These avoidable incidents can lead to the transmission of dangerous pathogens like HIV/AIDS, hepatitis C, measles and Methicillin-resistant Staphylococcus aureus.  More injuries are occurring with sutures, reusable scalpels, between steps of a multi-step procedure, and in the operating room (OR).  Find more details about the surveillance data at www.internationalsafetycenter.org. 

"We find the increase in contaminated sharps injuries incredibly concerning," commented Amber Mitchell, DrPH, MPH, CPH, president and executive director of the International Safety Center.  "The reports indicate inadequate use of safer medical devices, even though devices with sharps injury protections have been available for decades. We are also troubled that failure to use safer devices is especially high among physicians." To look more deeply into the root cause of these injuries, the Center has introduced new Exposure Prevention Information Network (EPINet®) injury reporting forms in 2018.

Sharps Injuries Rise for Physicians, in the OR, and with Safer Devices
For the first time in the 33 years since EPINet launched, physicians represent the highest percentage (34.2%) of workers reporting a sharps injury or needlestick, a marked rise compared to 29.2% in 2015. The ratio of injuries per average daily census (ADC) for all workers also increased, with 33.7 per 100 reported in 2016 compared to 31.7 in 2015.  Previously, nurses were the most affected worker segment, with an injury frequency of 33.4% in 2016 and 37.8% in 2015.  Health workers include not only caregivers, but also housekeeping, laundry and janitorial personnel.

The rise in injuries is associated with three major causes: failure to use a safer medical device; failure to activate safety mechanisms when devices with sharps injury protections are used; and unsafe work practices during multi-step processes (e.g., passing instruments by hand during surgical procedures). Of the less than one third (30.2%) of injured workers who reported using a device with a safety mechanism, over 60% did not activate the safety feature.

Blood and Body Fluid Exposures Increase in the OR and to Unprotected Eyes
BBFEs (e.g., splashes and splatters) have also increased, accounting for 12.9 per 100 ADC in 2016, versus 11.4 in 2015.

BBFEs are on the rise especially in the OR, accounting for 20% of exposures compared to all other departments.  Exposures mostly occur to unprotected skin by of workers who are not wearing personal protection equipment (PPE).  In 2016, more exposures occurred through gaps in protective clothing (5.3%), a marked increase from 2.9% in 2015. Nearly 50% of all BBFEs occurred in patient or exam rooms and almost 70% involved exposures to the eyes.  Less than 6% of workers indicate they were wearing eye protection during an exposure.

"These eye exposures are extremely troublesome, as the pathogens are contacting very high risk, mucus membranes which are also highly susceptible to viral and bacterial infectious disease and multidrug resistant organisms," observed Mitchell. "Co-infections with HIV and hepatitis or a multidrug resistant organism like MRSA are on the rise. A single incident can result in an occupational exposure to multiple pathogens."  

New Reporting Forms Capture More Data and Yield Deeper Insights
In 2018, the Center introduced new EPINet forms for reporting Needlestick and Sharp Object Injuries and Blood and Body Fluid Exposures. The new forms contain several key updates, including:

• sharps injuries from devices that were also used to administer hazardous drugs (e.g., chemotherapeutics, antineoplastics);
• safety mechanism type (e.g., sliding, sheath, hinge, retracting);
• devices with two needles (e.g., needles on front and back ends, including vacuum tube blood collection and insulin pens);
• employment status of injured worker (e.g., employee, contractor, student, volunteer).

The new forms are made possible by a generous grant from B Braun Medical.

"Since devices and drugs are more advanced than ever, it's important that the EPINet report forms keep up with these shifts," explained Ginger B. Parker, MBA, vice president and chief information officer.  "The updated forms are designed to reflect ongoing changes in the delivery of healthcare, including increased use of injectable therapeutics like insulin and hazardous drugs like chemotherapy."

The 2018 forms and accompanying User Manual are available on www.internationalsafetycenter.org. The forms, EPINet database, User Manual, and technical support are available to healthcare facilities around the world at no cost.

About the International Safety Center
The International Safety Center is committed to improving the safety and health of those working in healthcare. It is a women-led, nonprofit research and advocacy organization.  A global leader in occupational research and internationally recognized advocate for safer healthcare workplaces, the Center conducts epidemiological research, surveillance, and outreach to measure and prevent sharps injuries, needlesticks, and blood, and body fluid exposures. The Center operates the Exposure Prevention Information Network (EPINet), a free surveillance database that has been used to guide data-driven interventions, controls, and programs that protect healthcare workers since 1992. For more information about the Center, to participate in EPINet, or become a supporter, visit www.internationalsafetycenter.org. 

SOURCE International Safety Center

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